Data Exploration

Preliminary data exploration of all data sets extracted:

  1. One post-injury test (not merged with SIMS data)
  2. Two post-injury tests (not merged with SIMS data)
  3. Three post-injury tests (not merged with SIMS data)
  4. Four post-injury tests (not merged with SIMS data)
  5. One post-injury test (merged with SIMS)
  6. Two post-injury tests (merged with SIMS)
  7. Three post-injury tests (merged with SIMS)
  8. Four post-injury tests (merged with SIMS)

Of note, age range for all data sets was filtered to individuals between 12 - 18 years old.

Number of Observations per Data Set

Data Set Number of Observations
One post-injury test (not merged with SIMS) 9,991
One post-injury test (merged with SIMS) 257
Two post-injury tests (not merged with SIMS) 5,295
Two post-injury tests (merged with SIMS) 341
Three post-injury tests (not merged with SIMS) 2,228
Three post-injury tests (merged with SIMS) 143
Four post-injury tests (not merged with SIMS) 780
Four post-injury tests (merged with SIMS) 40

PCSS Score Description

Symptom Cluster Number of Items Total Possible Score
Headache-Migraine Cluster 3 18
Anxiety-Mood Cluster 5 30
Cognitive Cluster 4 24
Ocular-Motor Cluster 1 6
Vestibular Cluster 4 24
Sleep Cluster 5 30
Total Symptom Score 22 132

One Post-Injury Test (not merged with SIMS data)

Gender

Age

PCSS Summary

Total Symptom Score
Headache-Migraine Cluster
Anxiety-Mood Cluster
Cognitive Symptom Cluster
Ocular-Motor Cluster
Vestibular Cluster
Sleep Cluster

Two Post-Injury Tests (not merged with SIMS data)

Gender

Age Test 1

Age Test 2

PCSS Summary

Total Symptom Score 1
Total Symptom Score 2
Headache-Migraine Cluster 1
Headache-Migraine Cluster 2
Anxiety-Mood Cluster 1
Anxiety-Mood Cluster 2
Cognitive Symptom Cluster 1
Cognitive Symptom Cluster 2
Ocular-Motor Cluster 1
Ocular-Motor Cluster 2
Vestibular Cluster 1
Vestibular Cluster 2
Sleep Cluster 1
Sleep Cluster 2

Three Post-Injury Tests (not merged with SIMS data)

Gender

Age Test 1

Age Test 2

Age Test 3

PCSS Summary

Total Symptom Score 1
Total Symptom Score 2
Total Symptom Score 3
Headache-Migraine Cluster 1
Headache-Migraine Cluster 2
Headache-Migraine Cluster 3
Anxiety-Mood Cluster 1
Anxiety-Mood Cluster 2
Anxiety-Mood Cluster 3
Cognitive Symptom Cluster 1
Cognitive Symptom Cluster 2
Cognitive Symptom Cluster 3
Ocular-Motor Cluster 1
Ocular-Motor Cluster 2
Ocular-Motor Cluster 3
Vestibular Cluster 1
Vestibular Cluster 2
Vestibular Cluster 3
Sleep Cluster 1
Sleep Cluster 2
Sleep Cluster 3

Four Post-Injury Tests (not merged with SIMS data)

Gender

Age Test 1

Age Test 2

Age Test 3

Age Test 4

PCSS Summary

Total Symptom Score 1
Total Symptom Score 2
Total Symptom Score 3
Total Symptom Score 4
Headache-Migraine Cluster 1
Headache-Migraine Cluster 2
Headache-Migraine Cluster 3
Headache-Migraine Cluster 4
Anxiety-Mood Cluster 1
Anxiety-Mood Cluster 2
Anxiety-Mood Cluster 3
Anxiety-Mood Cluster 4
Cognitive Symptom Cluster 1
Cognitive Symptom Cluster 2
Cognitive Symptom Cluster 3
Cognitive Symptom Cluster 4
Ocular-Motor Cluster 1
Ocular-Motor Cluster 2
Ocular-Motor Cluster 3
Ocular-Motor Cluster 4
Vestibular Cluster 1
Vestibular Cluster 2
Vestibular Cluster 3
Vestibular Cluster 4
Sleep Cluster 1
Sleep Cluster 2
Sleep Cluster 3
Sleep Cluster 4

Non-merged Data Summary

Overall, average symptom severity decreases with consecutive testing. Also, the average symptom severity score is lower for individuals who complete one post-injury test that individuals who complete multiple post-injury tests, suggesting symptom severity on the first post-injury test is predictive of requiring multiple post-injury tests.

One post-injury test

9,991 concussion injuries

Symptom Cluster Mean Test 1 SD Test 1
Headache-Migraine Cluster 2.45 3.2
Anxiety-Mood Cluster 1.57 3.39
Cognitive Cluster 2.36 3.9
Ocular-Motor Cluster 0.29 0.82
Vestibular Cluster 1.57 2.82
Sleep Cluster 2.45 3.85
Total Symptom Score 10.7 15.57

Two post-injury tests

5,295 concussion injuries

Symptom Cluster Mean Test 1 SD Test 1 Mean Test 2 SD Test 2
Headache-Migraine Cluster 3.02 3.4 0.94 1.89
Anxiety-Mood Cluster 1.91 3.68 0.56 1.88
Cognitive Cluster 2.98 4.23 0.95 2.37
Ocular-Motor Cluster 0.36 0.92 0.1 0.44
Vestibular Cluster 2.01 3.1 0.45 1.37
Sleep Cluster 3.02 4.16 0.94 2.23
Total Symptom Score 13.31 16.76 3.94 8.62

Three post-injury tests

2,228 concussion injuries

Symptom Cluster Mean Test 1 SD Test 1 Mean Test 2 SD Test 2 Mean Test 3 SD Test 3
Headache-Migraine Cluster 3.55 3.6 1.34 2.23 0.57 1.45
Anxiety-Mood Cluster 2.32 3.99 0.76 2.17 0.39 1.62
Cognitive Cluster 3.68 4.67 1.39 2.86 0.63 1.98
Ocular-Motor Cluster 0.45 1 0.13 0.5 0.06 0.33
Vestibular Cluster 2.48 3.39 0.68 1.66 0.26 1.06
Sleep Cluster 3.62 4.47 1.37 2.69 0.59 1.79
Total Symptom Score 16.09 18.1 5.68 10.28 2.49 6.96

Four post-injury tests

780 concussion injuries

Symptom Cluster Mean Test 1 SD Test 1 Mean Test 2 SD Test 2 Mean Test 3 SD Test 3 Mean Test 4 SD Test 4
Headache-Migraine Cluster 4.04 3.66 1.83 2.54 0.99 1.91 0.6 1.66
Anxiety-Mood Cluster 2.7 4.3 1.07 2.64 0.63 2.04 0.43 1.99
Cognitive Cluster 4.31 5.02 2.08 3.5 1.12 2.65 0.68 2.37
Ocular-Motor Cluster 0.56 1.15 0.18 0.58 0.09 0.41 0.07 0.41
Vestibular Cluster 3.06 3.72 1.03 2.11 0.48 1.52 0.29 1.36
Sleep Cluster 4.28 4.85 1.98 3.25 0.98 2.35 0.54 1.87
Total Symptom Score 18.95 19.51 8.17 12.36 4.28 9.27 2.62 8.6

One Post-Injury Test (merged with SIMS data)

Gender

Age

PCSS Summary

Total Symptom Score
Headache-Migraine Cluster
Anxiety-Mood Cluster
Cognitive Symptom Cluster
Ocular-Motor Cluster
Vestibular Cluster
Sleep Cluster

RTL/RTP Summary

Injury Onset to Test Date
Injury Onset to RTL Completion
Injury Onset to RTP Completion
Plot 1

Plot 2

Plot 3

Two Post-Injury Tests (merged with SIMS data)

Gender

Age Test 1

Age Test 2

PCSS Summary

Total Symptom Score 1
Total Symptom Score 2
Headache-Migraine Cluster 1
Headache-Migraine Cluster 2
Anxiety-Mood Cluster 1
Anxiety-Mood Cluster 2
Cognitive Symptom Cluster 1
Cognitive Symptom Cluster 2
Ocular-Motor Cluster 1
Ocular-Motor Cluster 2
Vestibular Cluster 1
Vestibular Cluster 2
Sleep Cluster 1
Sleep Cluster 2

RTL/RTP Summary

Injury Onset to Test Date 1
Injury Onset to Test Date 2
Injury Onset to RTL Completion
Injury Onset to RTP Completion
Plot 1

Plot 2

Plot 3

Plot 4

Plot 5

Plot 6

Three Post-Injury Tests (merged with SIMS data)

Gender

Age Test 1

Age Test 2

Age Test 3

PCSS Summary

Total Symptom Score 1
Total Symptom Score 2
Total Symptom Score 3
Headache-Migraine Cluster 1
Headache-Migraine Cluster 2
Headache-Migraine Cluster 3
Anxiety-Mood Cluster 1
Anxiety-Mood Cluster 2
Anxiety-Mood Cluster 3
Cognitive Symptom Cluster 1
Cognitive Symptom Cluster 2
Cognitive Symptom Cluster 3
Ocular-Motor Cluster 1
Ocular-Motor Cluster 2
Ocular-Motor Cluster 3
Vestibular Cluster 1
Vestibular Cluster 2
Vestibular Cluster 3
Sleep Cluster 1
Sleep Cluster 2
Sleep Cluster 3

RTL/RTP Summary

Injury Onset to Test Date 1
Injury Onset to Test Date 2
Injury Onset to Test Date 3
Injury Onset to RTL Completion
Injury Onset to RTP Completion
Plot 1

Plot 2

Plot 3

Plot 4

Plot 5

Plot 6

Plot 7

Plot 8

Plot 9

Plot 10

Four Post-Injury Tests (merged with SIMS data)

Gender

Age Test 1

Age Test 2

Age Test 3

Age Test 4

PCSS Summary

Total Symptom Score 1
Total Symptom Score 2
Total Symptom Score 3
Total Symptom Score 4
Headache-Migraine Cluster 1
Headache-Migraine Cluster 2
Headache-Migraine Cluster 3
Headache-Migraine Cluster 4
Anxiety-Mood Cluster 1
Anxiety-Mood Cluster 2
Anxiety-Mood Cluster 3
Anxiety-Mood Cluster 4
Cognitive Symptom Cluster 1
Cognitive Symptom Cluster 2
Cognitive Symptom Cluster 3
Cognitive Symptom Cluster 4
Ocular-Motor Cluster 1
Ocular-Motor Cluster 2
Ocular-Motor Cluster 3
Ocular-Motor Cluster 4
Vestibular Cluster 1
Vestibular Cluster 2
Vestibular Cluster 3
Vestibular Cluster 4
Sleep Cluster 1
Sleep Cluster 2
Sleep Cluster 3
Sleep Cluster 4

RTL/RTP Summary

Injury Onset to Test Date 1
Injury Onset to Test Date 2
Injury Onset to Test Date 3
Injury Onset to Test Date 4
Injury Onset to RTL Completion
Injury Onset to RTP Completion
Plot 1

Plot 2

Plot 3

Plot 4

Plot 5

Plot 6

Plot 7

Plot 8

Plot 9

Plot 10

Plot 11

Plot 12

Plot 13

Plot 14

Plot 15

Merged Data Summary

Overall, the average duration of time from injury onset to RTL completion (RTP step 2) was shorter than the average duration of time from injury onset to post-injury test 1.

One post-injury test

257 concussion injuries

Benchmark Mean SD
Onset to Test 1 5.21 days 4.91 days
Onset to RTL completion 3.84 days 4.09 days
Onset to RTP completion 20.99 days 11.6 days

Two post-injury tests

341 concussion injuries

Benchmark Mean SD
Onset to Test 1 4.91 days 4.68 days
Onset to Test 2 9.72 days 5.89 days
Onset to RTL completion 3.87 days 4.16 days
Onset to RTP completion 21.23 days 10.12 days

Three post-injury tests

143 concussion injuries

Benchmark Mean SD
Onset to Test 1 5.18 days 5.03 days
Onset to Test 2 9.78 days 5.61 days
Onset to Test 3 14.59 days 6.97 days
Onset to RTL completion 3.86 days 4.02 days
Onset to RTP completion 25.02 days 10.97 days

Four post-injury tests

40 concussion injuries

Benchmark Mean SD
Onset to Test 1 6.5 days 6.3 days
Onset to Test 2 12.57 days 6.52 days
Onset to Test 3 17.4 days 7.52 days
Onset to Test 4 23.82 days 9.55 days
Onset to RTL completion 5.05 days 5.25 days
Onset to RTP completion 33.9 days 11.82 days

Similar to the non-merged data, average total symptom severity scores decrease with consecutive testing. Additionally, the average symptom severity scores on test 1 are higher for individuals who complete multiple post-injury tests.

One post-injury test

257 concussion injuries

Symptom Cluster Mean Test 1 SD Test 1
Headache-Migraine Cluster 2.63 3.42
Anxiety-Mood Cluster 1.81 3.55
Cognitive Cluster 2.58 4.2
Ocular-Motor Cluster 0.35 0.94
Vestibular Cluster 1.72 3.01
Sleep Cluster 2.72 4.03
Total Symptom Score 11.81 16.96

Two post-injury tests

341 concussion injuries

Symptom Cluster Mean Test 1 SD Test 1 Mean Test 2 SD Test 2
Headache-Migraine Cluster 2.81 3.29 0.74 1.61
Anxiety-Mood Cluster 1.78 3.33 0.34 1.18
Cognitive Cluster 2.86 4.13 0.76 1.95
Ocular-Motor Cluster 0.32 0.9 0.08 0.35
Vestibular Cluster 1.8 2.94 0.31 1.01
Sleep Cluster 2.56 3.7 0.7 1.82
Total Symptom Score 12.14 15.96 2.93 6.63

Three post-injury tests

143 concussion injuries

Symptom Cluster Mean Test 1 SD Test 1 Mean Test 2 SD Test 2 Mean Test 3 SD Test 3
Headache-Migraine Cluster 3.15 3.65 1.25 2.17 0.45 0.98
Anxiety-Mood Cluster 2.13 3.53 0.45 1.24 0.17 0.72
Cognitive Cluster 3.42 4.66 1.25 2.62 0.38 1.01
Ocular-Motor Cluster 0.42 1.02 0.12 0.44 0.01 0.12
Vestibular Cluster 2.19 3.41 0.52 1.27 0.09 0.35
Sleep Cluster 2.99 4.2 1.17 2.47 0.25 0.64
Total Symptom Score 14.31 17.98 4.76 8.73 1.36 2.54

Four post-injury tests

40 concussion injuries

Symptom Cluster Mean Test 1 SD Test 1 Mean Test 2 SD Test 2 Mean Test 3 SD Test 3 Mean Test 4 SD Test 4
Headache-Migraine Cluster 3.85 4.04 1.48 2.35 0.88 1.45 0.4 1.37
Anxiety-Mood Cluster 2.83 3.75 0.55 1.3 0.22 0.58 0.03 0.16
Cognitive Cluster 4.12 5.45 1.45 2.66 0.6 1.32 0.4 1.92
Ocular-Motor Cluster 0.65 1.44 0.07 0.35 0 0 0 0
Vestibular Cluster 2.83 4.28 0.7 1.59 0.1 0.38 0.12 0.65
Sleep Cluster 4.18 5.42 1.85 3.55 0.38 0.84 0.17 0.59
Total Symptom Score 18.45 21.52 6.1 10.32 2.17 3.1 1.12 4.3